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Relationship between outpatient antibiotic use and the prevalence of bacterial infections in Montenegro

Majda Šahman-Zaimović, Saša Vukmirović, Nataša Tomić

    Vojnosanitetski Pregled
    |January 20, 2018
    PubMed
    Abstract

    Insights

    Antibiotic use in Montenegro in 2012 was more than double the necessary amount, with less than half of prescriptions following national guidelines. This highlights a need to rationalize antibiotic quantities and types to combat resistance.

    Area of Science:

    • Public Health
    • Infectious Diseases
    • Pharmacoeconomics

    Background:

    • Overuse of antibiotics leads to side effects, reconsultations, and antimicrobial resistance.
    • Antibiotic use in Montenegro in 2011 was high (39.05 DDD/1,000 inhabitants/day) without considering bacterial disease prevalence.
    • Antimicrobial resistance is a growing global health concern.

    Purpose of the Study:

    • To assess the alignment between outpatient antibiotic consumption and bacterial infection prevalence in Montenegro.
    • To evaluate antibiotic prescribing patterns against national guidelines.

    Main Methods:

    • Antibiotic consumption data sourced from Montenegro's Agency for Medicines and Medical Devices for 2012.
    • Antibiotic quantities calculated using the Anatomic Therapeutic Chemical (ATC) Defined Daily Dose (DDD) methodology.
    • Outpatient bacterial infection prevalence data obtained from the Health Statistical Yearbook 2012.

    Main Results:

    • Outpatient antibiotic consumption in Montenegro was 30.34 DDD/1,000 inhabitants/day in 2012.
    • Penicillins, particularly amoxicillin and amoxicillin with clavulanic acid, were most frequently prescribed.
    • The prevalence of outpatient bacterial infections was 10.87 per 1,000 inhabitants, with respiratory tract infections being most common.
    • Less than 50% of antibiotic prescriptions adhered to national treatment guidelines.

    Conclusions:

    • Antibiotic use in Montenegro in 2012 exceeded requirements by over double, based on infection prevalence and treatment duration.
    • Prescribing patterns showed partial non-compliance with national guidelines but aligned with local antibiotic resistance data.
    • Urgent measures are needed to rationalize both the quantity and types of antibiotics prescribed in outpatient settings.

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